﻿<%@ Page Title="" Language="C#" MasterPageFile="~/Progress.master" AutoEventWireup="true" CodeFile="Registration.aspx.cs" Inherits="Web_Registration" %>

<%@ Register assembly="DevExpress.Web.ASPxEditors.v10.2, Version=10.2.3.0, Culture=neutral, PublicKeyToken=b88d1754d700e49a" namespace="DevExpress.Web.ASPxEditors" tagprefix="dx" %>
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<%@ Register assembly="DevExpress.XtraReports.v10.2.Web, Version=10.2.3.0, Culture=neutral, PublicKeyToken=b88d1754d700e49a" namespace="DevExpress.XtraReports.Web" tagprefix="dx" %>
<%@ Register assembly="DevExpress.XtraCharts.v10.2.Web, Version=10.2.3.0, Culture=neutral, PublicKeyToken=b88d1754d700e49a" namespace="DevExpress.XtraCharts.Web" tagprefix="dxchartsui" %>
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<%@ Register assembly="DevExpress.Web.ASPxScheduler.v10.2, Version=10.2.3.0, Culture=neutral, PublicKeyToken=b88d1754d700e49a" namespace="DevExpress.Web.ASPxScheduler" tagprefix="dxwschs" %>

<%@ Register assembly="DevExpress.Web.v10.2, Version=10.2.3.0, Culture=neutral, PublicKeyToken=b88d1754d700e49a" namespace="DevExpress.Web.ASPxPopupControl" tagprefix="dx" %>

<asp:Content ID="Content1" ContentPlaceHolderID="ContentPlaceHolder1" Runat="Server">

    <table class="style1">
        <tr>
            <td class="style7" 
                style="text-align: right; width: 167px; height: 31px; background-color: #F5F5F6;">
                </td>
            <td class="style48" 
                style="text-align: left; height: 31px; background-color: #F5F5F6;" colspan="3">
                <asp:Label ID="LabelMessage" runat="server" ForeColor="#339933"></asp:Label>
                <br />
                <asp:Label ID="disid" runat="server" Font-Size="Large" ForeColor="#0066FF"></asp:Label>
            </td>
            <td class="style4" 
                style="text-align: left; height: 31px; background-color: #F5F5F6;">
                </td>
            <td style="height: 31px; background-color: #F5F5F6;">
                </td>
        </tr>
        <tr>
            <td class="style7" 
                style="text-align: right; width: 167px; height: 60px; background-color: #F5F5F6;">
                </td>
            <td colspan="4" style="height: 60px; background-color: #F5F5F6;">
                <asp:Panel ID="Panel1" runat="server" Height="81px" 
                    style="background-color: #F5F5F6">
                    <img alt="" src="img/profile/123.jpg" 
    style="width: 700px; height: 80px" />
                </asp:Panel>
            </td>
            <td style="height: 60px">
                </td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                
                
                
                style="text-align: left; color: #35496A; background-color: #E4E4E4; font-family: Verdana; font-weight: bold; width: 289px;">
                REFERRER DETAILS</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #E4E4E4">
                &nbsp;</td>
            <td class="style4" style="text-align: left; background-color: #E4E4E4;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                style="text-align: left; background-color: #F9F9F9; width: 289px;">
                &nbsp;</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                &nbsp;</td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                
                
                style="text-align: left; color: #FF0000; font-family: Verdana; background-color: #F9F9F9; width: 289px;">
                Sponsor ID</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="TextBoxSuperID" runat="server" Width="200px" 
                    AutoPostBack="True" ontextchanged="TextBoxSuperID_TextChanged">
                </dx:ASPxTextBox>
            </td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                <asp:RequiredFieldValidator ID="RequiredFieldValidator36" runat="server" 
                    ControlToValidate="TextBoxSuperID" 
                    ErrorMessage="Please Enter Super Distributor ID" ForeColor="Red" 
                    Font-Size="8pt"></asp:RequiredFieldValidator>
            </td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                
                
                style="text-align: left; color: #FF0000; background-color: #F9F9F9; ">
                &nbsp;</td>
            <td class="dxpSeparator" 
                
                
                style="text-align: left; color: #FF0000; background-color: #F9F9F9; " 
                colspan="3">
            <asp:Label ID="LabelSupDisName" runat="server" 
                style="font-size: small; color: #0099FF;" Font-Size="Smaller"></asp:Label>
            </td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style13" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxpSeparator" 
                
                
                
                
                style="text-align: left; color: #35496A; background-color: #F9F9F9; font-family: Verdana; width: 289px;">
                    Agent ID</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="TextBoxAgentID" runat="server" 
                    ontextchanged="TextBoxAgentID_TextChanged" Width="200px" 
                    AutoPostBack="True">
                </dx:ASPxTextBox>
            </td>
            <td class="style16" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td class="style15">
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style13" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxpSeparator" 
                
                
                
                
                style="text-align: left; color: #35496A; background-color: #F9F9F9; font-family: Verdana; width: 289px;">
                    &nbsp;</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
            <asp:Label ID="LabelAgentName" runat="server" 
                style="font-size: small; color: #0099FF;" Font-Size="Smaller"></asp:Label>
            </td>
            <td class="style16" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td class="style15">
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style13" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxpSeparator" 
                
                
                
                
                style="text-align: left; color: #35496A; background-color: #F9F9F9; font-family: Verdana; width: 289px;">
                APIN</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <asp:DropDownList ID="APIN" runat="server" Width="200px" AutoPostBack="True" 
                    DataSourceID="SqlDataSource1" DataTextField="apin" DataValueField="apin" 
                    onselectedindexchanged="APIN_SelectedIndexChanged">
                </asp:DropDownList>
                <asp:SqlDataSource ID="SqlDataSource1" runat="server" 
                    ConnectionString="<%$ ConnectionStrings:MainConncrown %>" 
                    SelectCommand="SELECT [apin] FROM [dealerplacement] WHERE ([dealercode] = @dealercode)">
                    <SelectParameters>
                        <asp:ControlParameter ControlID="TextBoxAgentID" Name="dealercode" 
                            PropertyName="Text" Type="Int32" />
                    </SelectParameters>
                </asp:SqlDataSource>
            </td>
            <td class="style16" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td class="style15">
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style13" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxpSeparator" 
                
                
                
                
                style="text-align: left; color: #35496A; background-color: #F9F9F9; font-family: Verdana; width: 289px;">
                    &nbsp;</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                &nbsp;</td>
            <td class="style16" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td class="style15">
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style13" style="text-align: right; width: 167px;">
                    </td>
            <td class="dxpSeparator" 
                
                
                
                style="text-align: left; color: #35496A; background-color: #E4E4E4; font-family: Verdana; font-weight: bold; width: 289px;">
                    SELECT TEAM</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #E4E4E4">
                &nbsp;</td>
            <td class="style16" style="text-align: left; background-color: #E4E4E4;">
                </td>
            <td class="style15">
                </td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                
                style="text-align: left; background-color: #F9F9F9; width: 289px; color: #293955;">
                &nbsp;</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                &nbsp;</td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                style="text-align: left; background-color: #F9F9F9; width: 289px;">
                <asp:RadioButton ID="RadioButtonTeam1" runat="server" GroupName="Team" 
                    oncheckedchanged="RadioButtonTeam1_CheckedChanged" style="color: #2D3E5B" />
                <span style="color: #2D3E5B">Team 1</span></td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <asp:RadioButton ID="RadioButtonTeam2" runat="server" GroupName="Team" 
                    style="color: #2D3E5B" />
                <span style="color: #2D3E5B">Team 2</span></td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                style="text-align: left; background-color: #F9F9F9; width: 289px;">
                <asp:RadioButton ID="RadioButtonTeam3" runat="server" GroupName="Team" 
                    style="color: #2D3E5B" />
                <span style="color: #2D3E5B">Team 3</span></td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <asp:RadioButton ID="RadioButtonTeam4" runat="server" GroupName="Team" 
                    style="color: #2D3E5B" />
                <span style="color: #2D3E5B">Team 4</span></td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                style="text-align: left; background-color: #F9F9F9; width: 289px;">
                &nbsp;</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                &nbsp;</td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                
                
                
                style="text-align: left; color: #35496A; background-color: #E4E4E4; font-family: Verdana; font-weight: bold; width: 289px;">
                    LEAGLE&nbsp; NAME (IN ENGLISH)</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #E4E4E4">
                &nbsp;</td>
            <td class="style16" style="text-align: left; background-color: #E4E4E4;">
                </td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                style="text-align: left; background-color: #F9F9F9; width: 289px;">
                &nbsp;</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                &nbsp;</td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                
                style="text-align: left; background-color: #F9F9F9; width: 289px; color: #2D3E5B;">
                &nbsp;</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                &nbsp;</td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style27" style="text-align: right; width: 167px;">
                </td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                Distributor ID*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="TextBoxDisID" runat="server" Width="200px" 
                    BackColor="White">
                </dx:ASPxTextBox>
            </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td class="style28">
                </td>
        </tr>
        <tr>
            <td class="style24" style="text-align: right; width: 167px;">
                    </td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Surname*:</td>
            <td class="dxpSeparator" style="width: 64px; background-color: #F9F9F9;">
                <asp:DropDownList ID="ComboBoxTitle" runat="server">
                    <asp:ListItem Selected="True">Select Title</asp:ListItem>
                    <asp:ListItem>Dr.</asp:ListItem>
                    <asp:ListItem>Mr.</asp:ListItem>
                    <asp:ListItem>Miss.</asp:ListItem>
                    <asp:ListItem>Mrs.</asp:ListItem>
                    <asp:ListItem>Ms.</asp:ListItem>
                </asp:DropDownList>
            </td>
            <td class="dxpSeparator" style="background-color: #F9F9F9; ">
                <dx:ASPxTextBox ID="TextBoxSurName" runat="server" Width="100px">
                </dx:ASPxTextBox>
            </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td class="style25">
                </td>
        </tr>
        <tr>
            <td class="style30" style="text-align: right; width: 167px; height: 31px;">
                    </td>
            <td class="dxmLite" 
                
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px; height: 31px;">
                    Given Name*:</td>
            <td class="dxpSeparator" colspan="2" 
                style="background-color: #F9F9F9; height: 31px;">
                <dx:ASPxTextBox ID="TextBoxGivenName" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="dxpSeparator" 
                style="text-align: left; background-color: #F9F9F9; height: 31px;">
                &nbsp;</td>
            <td class="style31" style="height: 31px">
                </td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Cheque Name:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="TextBoxChequeName" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                style="text-align: left; background-color: #F9F9F9; width: 289px;">
                &nbsp;</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                &nbsp;</td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxpSeparator" 
                
                
                
                style="text-align: left; color: #35496A; background-color: #E4E4E4; font-family: Verdana; font-weight: bold; width: 289px;">
                    RESIDENTIAL ADDRESS</td>
            <td class="dxpSeparator" colspan="2" 
                style="background-color: #E4E4E4; color: #EEEEEE;">
                &nbsp;</td>
            <td class="style4" 
                style="text-align: left; background-color: #E4E4E4; color: #EEEEEE;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                style="text-align: left; background-color: #F9F9F9; width: 289px;">
                &nbsp;</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                &nbsp;</td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style30" style="text-align: right; width: 167px;">
                    </td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Address 1*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="TextBoxAdd1" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td class="style31">
                </td>
        </tr>
        <tr>
            <td class="style27" style="text-align: right; width: 167px;">
                    </td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Address 2:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="TextBoxAdd2" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td class="style28">
                </td>
        </tr>
        <tr>
            <td class="style27" style="text-align: right; width: 167px;">
                    </td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Town/City*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="TextBoxTownCity" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td class="style28">
                </td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    State/Province:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="TextBoxState" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxpSeparator" style="background-color: #F9F9F9; width: 289px;">
                    &nbsp;</td>
            <td class="dxpSeparator" colspan="3" style="background-color: #F9F9F9">
                    <asp:Label ID="Label3" runat="server" Font-Size="X-Small" ForeColor="Blue" 
                        Text="Note:Fill 0000 if your country does not have  Zip Code"></asp:Label>
                    </td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style45" style="text-align: right; width: 167px;">
                    </td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Postal/Zip Code*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="TextBoxZipCode" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                <br />
                <br />
            </td>
            <td class="style46">
                </td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Country</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <asp:DropDownList ID="ComboBoxCountry" runat="server" Width="200px">
                    <asp:ListItem Selected="True">Select Country</asp:ListItem>
                    <asp:ListItem>Sri Lanka</asp:ListItem>
                    <asp:ListItem>Australia</asp:ListItem>
                    <asp:ListItem>United Kindom</asp:ListItem>
                </asp:DropDownList>
            </td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxpSeparator" style="background-color: #F9F9F9; width: 289px;">
                    <br />
                </td>
            <td class="dxpSeparator" colspan="3" style="background-color: #F9F9F9">
                    <asp:Label ID="Label1" runat="server" Font-Size="X-Small" ForeColor="Blue" 
                        
                        Text="Note:Please use the format - CountryCode + Area Code + Phone Number. "></asp:Label>
                    <br />
                    <asp:Label ID="Label2" runat="server" Font-Size="X-Small" ForeColor="Blue" 
                        
                        Text="Do not include non-numeric characters. EG. for Australia : 61291239876"></asp:Label>
                </td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style33" style="text-align: right; width: 167px;">
                    </td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Home Phone No*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="TextBoxHomePhone" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                <br />
                <br />
            </td>
            <td class="style34">
                </td>
        </tr>
        <tr>
            <td class="style33" style="text-align: right; width: 167px;">
                    </td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Mobile Phone No*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="TextBoxMobileNo" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">


                <br />


                <br />
            </td>
            <td class="style34">
                </td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    eMail Address*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="TextBoxEmail" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                <br />
                <br />
            </td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Repeat eMail Address*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="TextBoxREmail" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                <br />
                <br />
                <br />
            </td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style13" style="text-align: right; width: 167px;">
                </td>
            <td class="dxpSeparator" 
                style="text-align: left; background-color: #F9F9F9; width: 289px;">
                </td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                </td>
            <td class="style16" style="text-align: left; background-color: #F9F9F9;">
                </td>
            <td class="style15">
                </td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxpSeparator" 
                
                
                
                style="text-align: left; color: #35496A; background-color: #EEEEEE; font-family: Verdana; font-weight: bold; width: 289px;">
                    SHIPPING ADDRESS</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #EEEEEE">
                <asp:CheckBox ID="CheckBox1" runat="server" AutoPostBack="True" Checked="True" 
                    oncheckedchanged="CheckBox1_CheckedChanged" CssClass="dxmLite" />
                <span class="dxmLite">Same as Above</span></td>
            <td class="style4" 
                style="text-align: left; background-color: #EEEEEE; color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="style48" 
                style="text-align: left; background-color: #F9F9F9; width: 289px;">
                &nbsp;</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                &nbsp;</td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style30" style="text-align: right; width: 167px;">
                    </td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Contact Person*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="ShipTextBoxContact" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                <asp:RequiredFieldValidator ID="RequiredFieldValidatorContact" runat="server" 
                    ControlToValidate="ShipTextBoxContact" 
                    ErrorMessage="Please Enter Contact Person" ForeColor="Red" Font-Size="8pt"></asp:RequiredFieldValidator>
            </td>
            <td class="style31">
                </td>
        </tr>
        <tr>
            <td class="style30" style="text-align: right; width: 167px;">
                    </td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Address 1*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="ShipTextBoxAdd1" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                <asp:RequiredFieldValidator ID="RequiredFieldValidatorAdd1" runat="server" 
                    ControlToValidate="ShipTextBoxAdd1" ErrorMessage="Please Enter Address 1" 
                    ForeColor="Red" Font-Size="8pt"></asp:RequiredFieldValidator>
            </td>
            <td class="style31">
                </td>
        </tr>
        <tr>
            <td class="style30" style="text-align: right; width: 167px;">
                    </td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Address 2*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="ShipTextBoxAdd2" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                <asp:RequiredFieldValidator ID="RequiredFieldValidatorAdd2" runat="server" 
                    ControlToValidate="ShipTextBoxAdd2" ErrorMessage="Please Enter Address 2" 
                    ForeColor="Red" Font-Size="8pt"></asp:RequiredFieldValidator>
            </td>
            <td class="style31">
                </td>
        </tr>
        <tr>
            <td class="style36" style="text-align: right; width: 167px;">
                    </td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Town/City*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="ShipTextBoxTownCity" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                <asp:RequiredFieldValidator ID="RequiredFieldValidatorTownCity" runat="server" 
                    ControlToValidate="ShipTextBoxTownCity" 
                    ErrorMessage="Please Enter Town/City" ForeColor="Red" Font-Size="8pt"></asp:RequiredFieldValidator>
            </td>
            <td class="style37">
                </td>
        </tr>
        <tr>
            <td class="style17" style="text-align: right; width: 167px;">
                    </td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    State/Provice:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="ShipTextBoxState" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="style20" style="text-align: left; background-color: #F9F9F9;">
                </td>
            <td class="style19">
                </td>
        </tr>
        <tr>
            <td class="style17" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxpSeparator" 
                style="color: #35496A; background-color: #F9F9F9; width: 289px;">
                    &nbsp;</td>
            <td class="dxpSeparator" colspan="3" style="background-color: #F9F9F9">
                    <asp:Label ID="Label4" runat="server" Font-Size="X-Small" ForeColor="Blue" 
                        Text="Note:Fill 0000 if your country does not have  Zip Code"></asp:Label>
                    </td>
            <td class="style19">
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Postal/Zip Code*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="ShipTextBoxZipCode" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                <asp:RequiredFieldValidator ID="RequiredFieldValidatorZipCode" runat="server" 
                    ControlToValidate="ShipTextBoxZipCode" 
                    ErrorMessage="Please Enter Zip Code" ForeColor="Red" Font-Size="8pt"></asp:RequiredFieldValidator>
                <br />
                <asp:RegularExpressionValidator ID="RegularExpressionValidatorZipNumber" runat="server" 
                    ControlToValidate="ShipTextBoxZipCode" ErrorMessage="Numbers Only" 
                    ValidationExpression="^\d+$" ForeColor="Red" Font-Size="8pt"></asp:RegularExpressionValidator>
                <br />
            </td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style30" style="text-align: right; width: 167px;">
                    </td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Country*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <asp:DropDownList ID="ShipComboBoxCountry" runat="server" Width="200px">
                    <asp:ListItem Selected="True" Value="Select_Country">Select Country</asp:ListItem>
                    <asp:ListItem>Sri Lanka</asp:ListItem>
                    <asp:ListItem>Australia</asp:ListItem>
                    <asp:ListItem>United Kindom</asp:ListItem>
                </asp:DropDownList>
            </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                <asp:RequiredFieldValidator ID="RequiredFieldValidatorCountry" runat="server" 
                    ControlToValidate="ShipComboBoxCountry" 
                    ErrorMessage="Please Select Country" ForeColor="Red" Font-Size="8pt"></asp:RequiredFieldValidator>
            </td>
            <td class="style31">
                </td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px; height: 28px;">
                    </td>
            <td class="dxmLite" 
                
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px; height: 28px;">
                    Phone No*:</td>
            <td class="dxpSeparator" colspan="2" 
                style="background-color: #F9F9F9; height: 28px;">
                <dx:ASPxTextBox ID="ShipTextBoxPhone" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="style4" 
                style="text-align: left; background-color: #F9F9F9; height: 28px;">
                <asp:RequiredFieldValidator ID="RequiredFieldValidatorPhoneNo" runat="server" 
                    ControlToValidate="ShipTextBoxPhone" ErrorMessage="Please Enter Phone No" 
                    ForeColor="Red" Font-Size="8pt"></asp:RequiredFieldValidator>
                <br />
                <asp:RegularExpressionValidator ID="RegularExpressionValidatorPhoneNumberOnly" runat="server" 
                    ControlToValidate="ShipTextBoxPhone" ErrorMessage="Numbers Only" 
                    ValidationExpression="^\d+$" ForeColor="Red" Font-Size="8pt"></asp:RegularExpressionValidator>
            </td>
            <td style="height: 28px">
                </td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Mobile No*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="ShipTextBoxMobile" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                <asp:RequiredFieldValidator ID="RequiredFieldValidatorMobileNo" runat="server" 
                    ControlToValidate="ShipTextBoxMobile" 
                    ErrorMessage="Please Enter Mobile No" ForeColor="Red" Font-Size="8pt"></asp:RequiredFieldValidator>
                <br />
                <asp:RegularExpressionValidator ID="RegularExpressionValidatorMobileNoNumber" runat="server" 
                    ControlToValidate="ShipTextBoxMobile" ErrorMessage="Numbers Only" 
                    ValidationExpression="^\d+$" ForeColor="Red" Font-Size="8pt"></asp:RegularExpressionValidator>
            </td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    eMail Address*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="ShipTextBoxEmail" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                <asp:RequiredFieldValidator ID="RequiredFieldValidatorEmail" runat="server" 
                    ControlToValidate="ShipTextBoxEmail" 
                    ErrorMessage="Please Enter Email Address" ForeColor="Red" Font-Size="8pt"></asp:RequiredFieldValidator>
                <br />
                <asp:RegularExpressionValidator ID="RegularExpressionValidatorEmailVal" runat="server" 
                    ControlToValidate="ShipTextBoxEmail" 
                    ErrorMessage="Please Enter Valid Email Address" 
                    ValidationExpression="\w+([-+.']\w+)*@\w+([-.]\w+)*\.\w+([-.]\w+)*" 
                    ForeColor="Red" Font-Size="8pt"></asp:RegularExpressionValidator>
                <br />
            </td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style13" style="text-align: right; width: 167px;">
                </td>
            <td class="dxpSeparator" 
                style="text-align: left; background-color: #F9F9F9; width: 289px;">
                </td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                &nbsp;</td>
            <td class="style16" style="text-align: left; background-color: #F9F9F9;">
                </td>
            <td class="style15">
                </td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxpSeparator" 
                
                
                
                style="text-align: left; color: #35496A; background-color: #EEEEEE; font-family: Verdana; font-weight: bold; width: 289px;">
                    PERSONAL DETAILS</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #EEEEEE">
                &nbsp;</td>
            <td class="style4" style="text-align: left; background-color: #EEEEEE;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                style="text-align: left; background-color: #F9F9F9; width: 289px;">
                &nbsp;</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                &nbsp;</td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                
                style="text-align: left; background-color: #F9F9F9; width: 289px; font-family: Verdana; color: #293955;">
                Valid ID Type*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <asp:DropDownList ID="ComboBoxValidIDType" runat="server" Width="200px">
                    <asp:ListItem Selected="True">Select ID Type</asp:ListItem>
                    <asp:ListItem>Bank Account Number</asp:ListItem>
                    <asp:ListItem>Comapny ID</asp:ListItem>
                    <asp:ListItem>Drivers License</asp:ListItem>
                    <asp:ListItem>Family Ration Card</asp:ListItem>
                    <asp:ListItem>Goverment ID</asp:ListItem>
                    <asp:ListItem>ID No</asp:ListItem>
                    <asp:ListItem>National IC</asp:ListItem>
                    <asp:ListItem>Not Specified</asp:ListItem>
                    <asp:ListItem>Passport</asp:ListItem>
                    <asp:ListItem>Social Security Number</asp:ListItem>
                    <asp:ListItem>Tax ID Number</asp:ListItem>
                    <asp:ListItem>TC ID</asp:ListItem>
                    <asp:ListItem>Voter ID</asp:ListItem>
                </asp:DropDownList>
            </td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style30" style="text-align: right; width: 167px;">
                    </td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    ID No*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="TextBoxValidIDNo" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td class="style31">
                </td>
        </tr>
        <tr>
            <td class="style27" style="text-align: right; width: 167px;">
                    </td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Nationality*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="TextBoxNationality" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td class="style28">
                </td>
        </tr>
        <tr>
            <td class="style27" style="text-align: right; width: 167px;">
                    </td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Date of Birth*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxDateEdit ID="DatePickerDOB" runat="server" Width="200px">
                </dx:ASPxDateEdit>
            </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td class="style28">
                </td>
        </tr>
        <tr>
            <td class="style30" style="text-align: right; width: 167px;">
                    </td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Occupation*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="TextBoxOccupation" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td class="style31">
                </td>
        </tr>
        <tr>
            <td class="style30" style="text-align: right; width: 167px;">
                    </td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Name and Address of Employement/Business:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="TextBoxNameofBusiness" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="style32" style="text-align: left; background-color: #F9F9F9;">
                </td>
            <td class="style31">
                </td>
        </tr>
        <tr>
            <td class="style27" style="text-align: right; width: 167px;">
                </td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                Office Tel No.:
            </td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="TextBoxOfficeNo" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td class="style28">
                </td>
        </tr>
        <tr>
            <td class="style36" style="text-align: right; width: 167px;">
                    </td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    &nbsp;</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                &nbsp;</td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td class="style37">
                </td>
        </tr>
        <tr>
            <td class="style36" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxpSeparator" 
                
                
                
                style="text-align: left; color: #35496A; background-color: #EEEEEE; font-family: Verdana; font-weight: bold; width: 289px;">
                    BENEFICIARY DETAILS</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #EEEEEE">
                &nbsp;</td>
            <td class="style4" style="text-align: left; background-color: #EEEEEE;">
                &nbsp;</td>
            <td class="style37">
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style36" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    &nbsp;</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                &nbsp;</td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td class="style37">
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style36" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Name of Beneficiary*: 
            </td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="BenTextBoxName" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td class="style37">
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style36" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Valid ID Type*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <asp:DropDownList ID="ComboBoxBenValidIDType" runat="server" Width="200px">
                    <asp:ListItem Selected="True">Select ID Type</asp:ListItem>
                    <asp:ListItem>Bank Account Number</asp:ListItem>
                    <asp:ListItem>Comapny ID</asp:ListItem>
                    <asp:ListItem>Drivers License</asp:ListItem>
                    <asp:ListItem>Family Ration Card</asp:ListItem>
                    <asp:ListItem>Goverment ID</asp:ListItem>
                    <asp:ListItem>ID No</asp:ListItem>
                    <asp:ListItem>National IC</asp:ListItem>
                    <asp:ListItem>Not Specified</asp:ListItem>
                    <asp:ListItem>Passport</asp:ListItem>
                    <asp:ListItem>Social Security Number</asp:ListItem>
                    <asp:ListItem>Tax ID Number</asp:ListItem>
                    <asp:ListItem>TC ID</asp:ListItem>
                    <asp:ListItem>Voter ID</asp:ListItem>
                </asp:DropDownList>
            </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td class="style37">
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style36" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    ID No*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="BenTextBoxValidIDNo" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td class="style37">
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style27" style="text-align: right; width: 167px;">
                    </td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Relationship*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <asp:DropDownList ID="BenComboBoxRelationship" runat="server" Width="200px">
                    <asp:ListItem Selected="True">Select Relationship</asp:ListItem>
                    <asp:ListItem>Brother</asp:ListItem>
                    <asp:ListItem>Sister</asp:ListItem>
                    <asp:ListItem>Father</asp:ListItem>
                    <asp:ListItem>Mother</asp:ListItem>
                    <asp:ListItem>Son</asp:ListItem>
                    <asp:ListItem>Daughter</asp:ListItem>
                    <asp:ListItem>Spouse</asp:ListItem>
                    <asp:ListItem>Other</asp:ListItem>
                </asp:DropDownList>
            </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td class="style28">
                </td>
        </tr>
        <tr>
            <td class="style30" style="text-align: right; width: 167px;">
                    </td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Address1:*</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="BenTextBoxAdd1" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td class="style31">
                </td>
        </tr>
        <tr>
            <td class="style27" style="text-align: right; width: 167px;">
                    </td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Address2:*</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="BenTextBoxAdd2" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td class="style28">
                </td>
        </tr>
        <tr>
            <td class="style30" style="text-align: right; width: 167px;">
                    </td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Town/City*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="BenTextBoxTown" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td class="style31">
                </td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    State/Provice:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="BenTextBoxState" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                style="text-align: left; background-color: #F9F9F9; width: 289px;">
                &nbsp;</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                    <asp:Label ID="Label5" runat="server" Font-Size="X-Small" ForeColor="Blue" 
                        Text="Note:Fill 0000 if your country does not have  Zip Code"></asp:Label>
                    </td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                
                style="text-align: left; background-color: #F9F9F9; width: 289px; font-family: Verdana; color: #293955;">
                    Postal/Zip Code*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="BenTextBoxZipCode" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                <br />
            </td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                style="text-align: left; background-color: #F9F9F9; width: 289px;">
                &nbsp;</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                &nbsp;</td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                
                
                
                style="text-align: left; color: #35496A; background-color: #EEEEEE; font-family: Verdana; font-weight: bold; width: 289px;">
                    BANKING&nbsp; INFORMATION</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #EEEEEE">
                &nbsp;</td>
            <td class="style4" style="text-align: left; background-color: #EEEEEE;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                style="text-align: left; background-color: #F9F9F9; width: 289px;">
                &nbsp;</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                &nbsp;</td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                
                style="text-align: left; background-color: #F9F9F9; width: 289px; font-family: Verdana; color: #2D3E5C;">
                Bank Name*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="BankTextBoxName" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                
                style="text-align: left; background-color: #F9F9F9; width: 289px; font-family: Verdana; color: #2D3E5C;">
                Bank Code*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="BankTextBoxCode" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                
                style="text-align: left; background-color: #F9F9F9; width: 289px; font-family: Verdana; color: #2D3E5C;">
                Branch Name*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="BankTextBoxBranch" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                
                style="text-align: left; background-color: #F9F9F9; width: 289px; font-family: Verdana; color: #2D3E5C;">
                BR/Code*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="BankTextBoxBRCode" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                
                style="text-align: left; background-color: #F9F9F9; width: 289px; font-family: Verdana; color: #2D3E5C;">
                Account No*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="BankTextBoxAccount" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                style="text-align: left; background-color: #F9F9F9; width: 289px;">
                &nbsp;</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                &nbsp;</td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxpSeparator" 
                
                
                
                style="text-align: left; color: #35496A; background-color: #EEEEEE; font-family: Verdana; font-weight: bold; width: 289px;">
                    B ACCOUNT SEQURITY QUESTION</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #EEEEEE">
                &nbsp;</td>
            <td class="style4" style="text-align: left; background-color: #EEEEEE;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                style="text-align: left; background-color: #F9F9F9; width: 289px;">
                &nbsp;</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                &nbsp;</td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style27" style="text-align: right; width: 167px;">
                    </td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Security Question*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <asp:DropDownList ID="ComboBoxSecurityQuestion" runat="server" Width="200px">
                    <asp:ListItem Selected="True" Value="Select_Question">Select Question</asp:ListItem>
                    <asp:ListItem Value="What's_Your_1st_School?">What&#39;s Your 1st School?</asp:ListItem>
                    <asp:ListItem Value="What's_Your_1st_Job?">What&#39;s Your 1st Job?</asp:ListItem>
                    <asp:ListItem Value="Where_is_Your_Home_Town?">Where is Your Home Town?</asp:ListItem>
                </asp:DropDownList>
            </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td class="style28">
                </td>
        </tr>
        <tr>
            <td class="style27" style="text-align: right; width: 167px;">
                    </td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Your Answer*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="TextBoxSA" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td class="style28">
                </td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Security Word*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="TextBoxSW" runat="server" Width="200px">
                </dx:ASPxTextBox>
            </td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                style="text-align: left; background-color: #F9F9F9; width: 289px;">
                &nbsp;</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                &nbsp;</td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxpSeparator" 
                
                
                
                style="text-align: left; color: #35496A; background-color: #EEEEEE; font-family: Verdana; font-weight: bold; width: 289px;">
                    CHOOSE A B ACCOUNT PIN</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #EEEEEE">
                &nbsp;</td>
            <td class="style4" style="text-align: left; background-color: #EEEEEE;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style13" style="text-align: right; width: 167px;">
                </td>
            <td class="dxpSeparator" 
                style="text-align: left; background-color: #F9F9F9; width: 289px;">
                </td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                </td>
            <td class="style15">
                </td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    B Crown Pin*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="TextBoxQAPin" runat="server" Width="200px" Password="True">
                </dx:ASPxTextBox>
            </td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                <br />
                <br />
            </td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                Retype B Crown Pin*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="TextBoxRQAPin" runat="server" Width="200px" Password="True">
                </dx:ASPxTextBox>
            </td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                <br />
                <br />
                <br />
            </td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                style="text-align: left; background-color: #F9F9F9; width: 289px;">
                &nbsp;</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                &nbsp;</td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxpSeparator" 
                
                
                
                style="text-align: left; color: #35496A; background-color: #EEEEEE; font-family: Verdana; font-weight: bold; width: 289px;">
                    CHOOSE A USER NAME AND PASSWORD</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #EEEEEE">
                &nbsp;</td>
            <td class="style4" style="text-align: left; background-color: #EEEEEE;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td class="style13" style="text-align: right; width: 167px;">
                </td>
            <td class="dxpSeparator" 
                style="text-align: left; background-color: #F9F9F9; width: 289px;">
                </td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                </td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
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            <td class="style15">
                </td>
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        <tr>
            <td class="style13" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9; width: 289px; color: #293955; font-family: Verdana;">
                User Name</td>
                </td>
                <a id="username"></a>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="TextBoxUserName" runat="server" Width="200px" 
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            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td class="style15">
                &nbsp;</td>
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        <tr>
            <td class="style13" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                
                style="text-align: left; background-color: #F9F9F9; width: 289px; color: #293955; font-family: Verdana;">
                &nbsp;</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <asp:Label ID="Availability" runat="server" ForeColor="#339933"></asp:Label>
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            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
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            <td class="style15">
                &nbsp;</td>
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        <tr>
            <td class="style27" style="text-align: right; width: 167px;">
                    </td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Password*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="TextBoxPass" runat="server" Width="200px" Password="True">
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            <td class="dxpSeparator" style="text-align: left; background-color: #F9F9F9;">
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            <td class="style28">
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        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Retype Password*:</td>
            <td class="dxpSeparator" colspan="2" style="background-color: #F9F9F9">
                <dx:ASPxTextBox ID="TextBoxRPass" runat="server" Width="200px" Password="True">
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            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                <br />
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            <td>
                &nbsp;</td>
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        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                    &nbsp;</td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                    Personal URL*:</td>
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                <span class="dxmLite">.bestlife.lk</span></td>
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            <td>
                &nbsp;</td>
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        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
                style="text-align: left; background-color: #F9F9F9; width: 289px;">
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                &nbsp;</td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
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        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxmLite" 
                
                
                style="text-align: left; background-color: #F9F9F9; font-family: Verdana; color: #35496A; width: 289px;">
                Upload Your Picture</td>
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                <asp:FileUpload ID="FileUpload1" runat="server"   />
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            <td>
                &nbsp;</td>
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        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
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                &nbsp;</td>
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                &nbsp;</td>
            <td class="style4" style="text-align: left; background-color: #F9F9F9;">
                &nbsp;</td>
            <td>
                &nbsp;</td>
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        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
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                &nbsp;</td>
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                &nbsp;</td>
            <td>
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        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="dxpSeparator" 
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            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
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                &nbsp;</td>
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            <td>
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            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="style48" style="text-align: left; width: 289px;">
                &nbsp;</td>
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            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="style48" style="text-align: left; width: 289px;">
                &nbsp;</td>
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                &nbsp;</td>
            <td class="style4" style="text-align: left">
                &nbsp;</td>
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                &nbsp;</td>
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        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="style48" style="text-align: left; width: 289px;">
                &nbsp;</td>
            <td class="style57" colspan="2">
                &nbsp;</td>
            <td class="style4" style="text-align: left">
                &nbsp;</td>
            <td>
                &nbsp;</td>
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        <tr>
            <td class="style7" style="text-align: right; width: 167px;">
                &nbsp;</td>
            <td class="style48" style="text-align: left; width: 289px;">
                &nbsp;</td>
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                &nbsp;</td>
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                &nbsp;</td>
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